ATI RN
Gastrointestinal Assessment in Pediatrics Questions
Question 1 of 5
The nurse is caring for a 3-year-old who had an appendectomy 2 days ago. The child has a fever of 101.8°F (38.8°C) and slightly diminished breath sounds in the right lower lobe. Which action is most appropriate?
Correct Answer: B
Rationale: In this scenario, the most appropriate action is option B: Encourage the child to blow bubbles. This is the correct choice because the child is showing signs of atelectasis, which is a common complication post-appendectomy due to shallow breathing. Blowing bubbles can help improve lung expansion and prevent atelectasis by encouraging deep breathing and coughing. Option A is incorrect because teaching the child how to use an incentive spirometer may be too advanced for a 3-year-old and may not be as effective in promoting deep breathing as blowing bubbles. Option C is incorrect because obtaining an order for intravenous antibiotics is not indicated based solely on the child's symptoms of fever and diminished breath sounds. Antibiotics should be prescribed based on a confirmed diagnosis of infection. Option D is incorrect as administering Tylenol may help with fever management, but it does not address the underlying issue of atelectasis. In an educational context, it is crucial for nurses caring for pediatric patients to understand the importance of respiratory assessment and interventions to prevent complications like atelectasis. Teaching appropriate techniques like blowing bubbles can be a fun and effective way to promote respiratory function in young children post-surgery.
Question 2 of 5
The nurse is caring for a newborn with an anorectal malformation and a colostomy. The nurse knows that more education is needed when the infant's parent states which of the following?
Correct Answer: D
Rationale: The correct answer is D) As my baby grows, a pattern will develop over time, and there should be predictable bowel movements. This statement is inaccurate because infants with anorectal malformations and colostomies typically do not have predictable bowel movements due to the nature of their condition. It is important for parents to understand that bowel patterns may vary, and they should not expect a consistent schedule. Option A is incorrect because the stoma should be pink or red, indicating good blood flow. Option B is incorrect as some discharge and irritation around the stoma can be normal and should be managed appropriately. Option C is incorrect as it is important to allow some air exposure to the stoma to promote healing and prevent skin breakdown. In an educational context, it is crucial for nurses to provide accurate information to parents of infants with anorectal malformations and colostomies to ensure proper care and management of the stoma. Understanding the nuances of stoma care and bowel patterns can help parents effectively care for their child and prevent complications.
Question 3 of 5
The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about this infant's condition?
Correct Answer: A
Rationale: In caring for an infant with Hirschsprung disease, the nurse must understand the pathophysiology of the condition to provide appropriate care. The correct answer is A) There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention. In Hirschsprung disease, there is a lack of ganglion cells in the distal colon, causing a segment of the bowel to have no peristalsis, leading to the accumulation of stool, distention, and potential complications like enterocolitis. Option B) There is excessive peristalsis throughout the intestine, resulting in abdominal distention is incorrect as Hirschsprung disease is characterized by a lack of peristalsis, not excessive peristalsis. Option C) There is a small-bowel obstruction leading to ribbon-like stools is incorrect because Hirschsprung disease primarily affects the large intestine, not the small bowel. Option D) There is inflammation throughout the large intestine, leading to accumulation of intestinal contents and abdominal distention is incorrect because while there can be complications like enterocolitis, the primary issue in Hirschsprung disease is the lack of peristalsis due to missing ganglion cells. Understanding the specific manifestations of Hirschsprung disease is crucial for nurses caring for affected infants to provide appropriate interventions, monitor for complications, and educate families on managing the condition.
Question 4 of 5
The nurse is interviewing the parents of a 6-year-old who has been experiencing constipation. Which could be a causative factor? (Select all that apply.)
Correct Answer: D
Rationale: In pediatric gastrointestinal assessment, constipation is a common concern that requires a comprehensive understanding of potential causative factors. In this scenario, selecting all the options (A, B, and C) as causative factors for constipation in a 6-year-old child is the correct choice. - A) Hypothyroidism: Hypothyroidism can lead to decreased metabolic rate and affect gastrointestinal motility, potentially causing constipation in children. - B) Muscular dystrophy: Muscular weakness and impaired coordination of bowel movements associated with muscular dystrophy can contribute to constipation. - C) Myelomeningocele: Children with myelomeningocele often have neurological issues affecting bowel function, leading to constipation. Educationally, understanding these causative factors helps nurses in conducting thorough assessments, formulating appropriate care plans, and providing necessary interventions to manage constipation effectively in pediatric patients. By grasping the relationship between underlying conditions and gastrointestinal symptoms, nurses can promote optimal health outcomes for children experiencing constipation.
Question 5 of 5
The nurse knows that Nissen fundoplication involves which of the following?
Correct Answer: B
Rationale: Nissen fundoplication involves wrapping the fundus of the stomach around the inferior esophagus, mimicking a cardiac sphincter. This procedure is commonly performed to treat gastroesophageal reflux disease (GERD) in pediatric patients. By creating a new "valve" at the gastroesophageal junction, it helps prevent stomach acid from backing up into the esophagus. Option A is incorrect because wrapping the fundus around the inferior stomach would not address the issue of reflux effectively. Option C is incorrect as wrapping the fundus around the middle portion of the stomach would not impact reflux. Option D is incorrect as dilating the fundus would not treat reflux but might exacerbate it. Understanding Nissen fundoplication is essential for pediatric nurses caring for patients with GERD. By grasping the rationale behind this surgical procedure, nurses can provide better pre- and post-operative care, educate families effectively, and recognize and manage complications promptly.